Your browser doesn't support javascript.
International controlled study of revascularization and outcomes following COVID-positive mechanical thrombectomy.
Dmytriw, Adam A; Ghozy, Sherief; Sweid, Ahmad; Piotin, Michel; Bekelis, Kimon; Sourour, Nader; Raz, Eytan; Vela-Duarte, Daniel; Linfante, Italo; Dabus, Guilherme; Kole, Max; Martínez-Galdámez, Mario; Nimjee, Shahid M; Lopes, Demetrius K; Hassan, Ameer E; Kan, Peter; Ghorbani, Mohammad; Levitt, Michael R; Escalard, Simon; Missios, Symeon; Shapiro, Maksim; Clarençon, Fréderic; Elhorany, Mahmoud; Tahir, Rizwan A; Youssef, Patrick P; Pandey, Aditya S; Starke, Robert M; El Naamani, Kareem; Abbas, Rawad; Mansour, Ossama Y; Galvan, Jorge; Billingsley, Joshua T; Mortazavi, Abolghasem; Walker, Melanie; Dibas, Mahmoud; Settecase, Fabio; Heran, Manraj K S; Kuhn, Anna L; Puri, Ajit S; Menon, Bijoy K; Sivakumar, Sanjeev; Mowla, Ashkan; D'Amato, Salvatore; Zha, Alicia M; Cooke, Daniel; Vranic, Justin E; Regenhardt, Robert W; Rabinov, James D; Stapleton, Christopher J; Goyal, Mayank.
  • Dmytriw AA; Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, Massachusetts, USA.
  • Ghozy S; Neuroradiology & Neurosurgery Services, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Sweid A; Neuroradiology & Neurosurgery Services, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Piotin M; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
  • Bekelis K; Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France.
  • Sourour N; Department of Neurosurgery, Good Samaritan Hospital Medical Center, New York, USA.
  • Raz E; Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
  • Vela-Duarte D; Department of Radiology, New York University Langone Medical Center, New York, New York, USA.
  • Linfante I; Department of Interventional Neuroradiology & Neuroendovascular Surgery, Miami Cardiac and Vascular Institute, Baptist Hospital of Miami, Miami, Florida, USA.
  • Dabus G; Department of Interventional Neuroradiology & Neuroendovascular Surgery, Miami Cardiac and Vascular Institute, Baptist Hospital of Miami, Miami, Florida, USA.
  • Kole M; Department of Interventional Neuroradiology & Neuroendovascular Surgery, Miami Cardiac and Vascular Institute, Baptist Hospital of Miami, Miami, Florida, USA.
  • Martínez-Galdámez M; Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
  • Nimjee SM; Department of Interventional Neuroradiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
  • Lopes DK; Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
  • Hassan AE; Department of Neurosurgery, Advocate Aurora Health, Chicago, Illinois, USA.
  • Kan P; Department of Neuroscience, Valley Baptist Medical Center/University of Texas Rio Grande Valley, Harlingen, Texas, USA.
  • Ghorbani M; Department of Neurosurgery, UTMB, Houston, Texas, USA.
  • Levitt MR; Department of Neurosurgery, Firoozgar Hospital, Tehran, Iran.
  • Escalard S; Departments of Neurological Surgery, Radiology, Mechanical Engineering, and Stroke & Applied Neuroscience Center, University of Washington, Seattle, Washington, USA.
  • Missios S; Department of Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France.
  • Shapiro M; Department of Neurosurgery, Good Samaritan Hospital Medical Center, New York, USA.
  • Clarençon F; Department of Radiology, New York University Langone Medical Center, New York, New York, USA.
  • Elhorany M; Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
  • Tahir RA; Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
  • Youssef PP; Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
  • Pandey AS; Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
  • Starke RM; Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
  • El Naamani K; Department of Neurosurgery & Neuroradiology, University of Miami & Jackson Memorial Hospital, Miami, Florida, USA.
  • Abbas R; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
  • Mansour OY; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
  • Galvan J; Department of Neurology, Alexandria University Hospital, Alexandria, Egypt.
  • Billingsley JT; Department of Interventional Neuroradiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
  • Mortazavi A; Department of Neurosurgery, Advocate Aurora Health, Chicago, Illinois, USA.
  • Walker M; Department of Neuroscience, Valley Baptist Medical Center/University of Texas Rio Grande Valley, Harlingen, Texas, USA.
  • Dibas M; Departments of Neurological Surgery, Radiology, Mechanical Engineering, and Stroke & Applied Neuroscience Center, University of Washington, Seattle, Washington, USA.
  • Settecase F; Neuroradiology & Neurosurgery Services, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • Heran MKS; Division of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
  • Kuhn AL; Division of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
  • Puri AS; Division of Neurointerventional Radiology, Department of Radiology, UMass Memorial Medical Center, Worcester, Massachusetts, USA.
  • Menon BK; Division of Neurointerventional Radiology, Department of Radiology, UMass Memorial Medical Center, Worcester, Massachusetts, USA.
  • Sivakumar S; Calgary Stroke Program, Cumming School of Medicine, Calgary, Alberta, Canada.
  • Mowla A; Department of Medicine (Neurology), Prisma Health Upstate, USC, Greenville, South Carolina, USA.
  • D'Amato S; Department of Neurological Surgery, University of Southern California, Los Angeles, California, USA.
  • Zha AM; Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, Massachusetts, USA.
  • Cooke D; Department of Neurology, UT Health Science Center, Houston, Texas, USA.
  • Vranic JE; Department of Neurointerventional Radiology, San Francisco General Hospital, San Francisco, California, USA.
  • Regenhardt RW; Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, Massachusetts, USA.
  • Rabinov JD; Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, Massachusetts, USA.
  • Stapleton CJ; Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, Massachusetts, USA.
  • Goyal M; Neuroendovascular Program, Mass General Brigham Partners, Harvard Medical School, Boston, Massachusetts, USA.
Eur J Neurol ; 29(11): 3273-3287, 2022 11.
Article in English | MEDLINE | ID: covidwho-1927584
ABSTRACT
BACKGROUND AND

PURPOSE:

Previous studies suggest that mechanisms and outcomes in patients with COVID-19-associated stroke differ from those in patients with non-COVID-19-associated strokes, but there is limited comparative evidence focusing on these populations. The aim of this study, therefore, was to determine if a significant association exists between COVID-19 status with revascularization and functional outcomes following thrombectomy for large vessel occlusion (LVO), after adjustment for potential confounding factors.

METHODS:

A cross-sectional, international multicenter retrospective study was conducted in consecutively admitted COVID-19 patients with concomitant acute LVO, compared to a control group without COVID-19. Data collected included age, gender, comorbidities, clinical characteristics, details of the involved vessels, procedural technique, and various outcomes. A multivariable-adjusted analysis was conducted.

RESULTS:

In this cohort of 697 patients with acute LVO, 302 had COVID-19 while 395 patients did not. There was a significant difference (p < 0.001) in the mean age (in years) and gender of patients, with younger patients and more males in the COVID-19 group. In terms of favorable revascularization (modified Thrombolysis in Cerebral Infarction [mTICI] grade 3), COVID-19 was associated with lower odds of complete revascularization (odds ratio 0.33, 95% confidence interval [CI] 0.23-0.48; p < 0.001), which persisted on multivariable modeling with adjustment for other predictors (adjusted odds ratio 0.30, 95% CI 0.12-0.77; p = 0.012). Moreover, endovascular complications, in-hospital mortality, and length of hospital stay were significantly higher among COVID-19 patients (p < 0.001).

CONCLUSION:

COVID-19 was an independent predictor of incomplete revascularization and poor functional outcome in patients with stroke due to LVO. Furthermore, COVID-19 patients with LVO were more often younger and had higher morbidity/mortality rates.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Brain Ischemia / Stroke / Endovascular Procedures / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans / Male Language: English Journal: Eur J Neurol Journal subject: Neurology Year: 2022 Document Type: Article Affiliation country: Ene.15493

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Brain Ischemia / Stroke / Endovascular Procedures / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Humans / Male Language: English Journal: Eur J Neurol Journal subject: Neurology Year: 2022 Document Type: Article Affiliation country: Ene.15493